Before the patient is allowed to absolve the medical training therapy, it is mandatory that the patient is thoroughly investigated and asked on the basis of an internationally proved algorithm. In this 60 minutes lasting first investigation our spine-specialist Dr. Bernhard Stengg will check, if there where contraindications (like malign hypertonia, instabile angina pectoris, acute pain due to fracture, inflammation, tumor,....) for the maximumstrength analysis of all relevant spinal stabilizers. In most of the cases such a pc-controlled muscletest can be performed without any restrictions, or risk of pain aggravation. If the original chronic back pain is still too strong, to get valid results, Dr. Stengg will treat you (in the average out of 7000 patients - 2-4 treatment sessions) with a individualized combinationtherapy.
What is the rationale behind the persuasion of the effectiveness of muscular reconditioning of spinal stabilizers in chronic spinal pain?
Already 15 years ago the interational scientific community had begun to systematically prove the overwhelming importance of the 3-dimensional musclecorset of our spine in breaking the vitious circle of chronic spinal pain. Nowadays we finally know, why a simple backpain in about 10% of the backpain patients develops to a permanent massive paindisease with nearly no longterm chance for an acceptable quality of life.
Pain leads to relieving postures and movements as well as a painavoiding behaviour. So if the pain is originating from an inflamed nerveroot either in the cervical or lumbar spine, the patient avoids to lean back respectively to the side. But if one reduces the frequency and intensity of these movements, the responsable muscles get weaker and finally atrophy. This leads to just more instability in the involved segments, so the pain will increase permanently - now also coming from the overloaded capsules, ligaments, tendons and fasciae. Consequently the relieving strategies will increase and so on....
This circle can only be broken with an intensive cared complex trainingtherapy of the 3-dimensional spinal stabilizers. To do so it turned out that such a strengthening program has to be maximum effective but also maximum safe! So in the late 90-ies very special machines were build, where every person between 130-200cm can be fixed and trained very precisely. The next milestone was created by collect a reference databanc from 4000 healthy subjects, so that the values of every patient can be compared with the values of a healthy person of the same height, weight, gender and age. Based on these findings the most personal trainingtherapy program can be created since strengthening exercises were guided ever! The programs last 12 weeks and twice weekly, following international recommendations, that in the average it lasts 3 months, until the structural remodeling in the muscles has been established.
The results from Germany as well as the data from >4000 own patients showed: 90% of the patients could reach their target values. In 90% out of those, the chronic pain could be reduced to at least the half of their original painintensity reaching up to total painfreedom. The longterm data, we have been collecting since more than 10 years, revealed that 90% of the painpatients had a significant reduction of painfrequency, duration of the painepisodes and intensity of these painepisodes. Amazingly we found no relevant differences in the positive, clinical results regarding age (the oldest successfully treated backpain patient was 91 years old), gender and diagnosis (unless the structural damage was too marked).
As negative predictors for a clinical success, we could identify: polymorbid locomotor apparatus with multiple operations and marked psychosocial comorbidities (the "biological" part of the pain improves just to a maximum of 50%, but together with behavioural-therapy-based paincoping groups the overall result can increase up to 70%). Further more a BMI of >30 and a marked phlegmatic personality also showed results that where much worse than the majority of patients.
To guarantee the high effectivity as well as the high safety during the intense strengthening therapy program, a high level of quality is necessary in the equipment, but more than this in the trainingtherapeuts. Everyone of them has to absolve 3-months of a special sportmedical and training-therapeutical enrolment by Dr. Stengg. To work on this high level, one of the training therapeuts cares for a maximum of 2-3 patients at once unless we have a 1:1 setting. At the beginning and the end of the individual training therapy Dr. Stengg by himself will speak about the results with you and create the most fitting and detailed plan, which will lead you safely through your paindisease to a >90% normal quality of life again.